CAJ | 학술논문

目的探讨18F-脱氧葡萄糖(FDG)PET/CT检查评估肝细胞肝癌(HCC)经导管肝动脉化疗栓塞(TACE)治疗后肿瘤活性及对转移灶的检出能力.方法 22例HCC患者TACE后进行18F-FDG PET/CT检查,以临床随访及部分病理结果为标准进行对照分析.结果 22例患者中,18例复发或转移,其余4例全身未见明显FDG代谢异常增高灶.16例患者肝内有1个或多个18F-FDG放射性增高灶,其中5例碘油沉积区和非碘油沉积区均有FDG浓聚灶,13例并发肝外转移病灶;2例肝内FDG显像阴性但腹膜后淋巴结放射性浓聚.转移灶分布:肺和淋巴结转移各9例,骨转移2例,门静脉瘤栓和膈脚转移各1例.经随访证实2例肝内18F-FDG显像为假阴性,18F-FDG PET/CT检查对肝内肿瘤复发或转移灶的探测灵敏度为88.9%(16/18),特异性为4/4,准确性为90.9%(20/22);全身显像对肿瘤复发或转移检测的灵敏度为94.7%(18/19),特异性为3/3,准确性为95.5%(21/22).结论 18F-FDG PET/CT显像对HCC介入治疗后的残留或复发灶探测有较高的灵敏度,对肝外转移病灶的检出具有独特的优势.
목적 탐토18F-탈양포도당(FDG)PET/CT검사평고간세포간암(HCC)경도관간동맥화료전새(TACE)치료후종류활성급대전이조적검출능력.방법 22례HCC환자TACE후진행18F-FDG PET/CT검사,이림상수방급부분병리결과위표준진행대조분석.결과 22례환자중,18례복발혹전이,기여4례전신미견명현FDG대사이상증고조.16례환자간내유1개혹다개18F-FDG방사성증고조,기중5례전유침적구화비전유침적구균유FDG농취조,13례병발간외전이병조;2례간내FDG현상음성단복막후림파결방사성농취.전이조분포:폐화림파결전이각9례,골전이2례,문정맥류전화격각전이각1례.경수방증실2례간내18F-FDG현상위가음성,18F-FDG PET/CT검사대간내종류복발혹전이조적탐측령민도위88.9%(16/18),특이성위4/4,준학성위90.9%(20/22);전신현상대종류복발혹전이검측적령민도위94.7%(18/19),특이성위3/3,준학성위95.5%(21/22).결론 18F-FDG PET/CT현상대HCC개입치료후적잔류혹복발조탐측유교고적령민도,대간외전이병조적검출구유독특적우세.
Objective Accurate evaluation of treatment result of transcatheter arterial chemoembo-lization (TACE) in patients with hepatocellular carcinoma (HCC) by conventional imaging is difficult. The objective of this study was to investigate the clinical value of 18F-fluorodeoxyglucose (FI)G) PET/CT for de-tecting residual viable tumor, recurrence and metastases in patients with HCC after TACE. Methods Twenty-two patients with HCC after TACE were investigated with 18F-FDG PET/CT. The accuracy of FDG PET/CT was determined by the histopathological results or evidences of clinical follow-up. Results Of all 22 HCC patients after TACE, 18 had intra- and (or) extrahepatic lesions, detected by FDG PET/CT. Six-teen patients had intrahepatic FDG-avid lesion(s). Of the 16 patients, five had intrahepatic FDG-avid le-sions located at both lipiodol-rich and -deprive regions, 13 had associated extrahepatic metastases. Of the two HCC patients who had no intrahepatic FDG-avid lesion, there were extrahepatic FDG-avid lesions at the retroperitoneal lymph nodes. In all, 15 HCC had extrahepatic lesions identified by FDG PET/CT. There were lung and lymph nodes (n = 9), bone (n = 2), tumor thrombus at portal vein (n - 1) and diaphragm crus (n = 1). Two patients were false negative. The sensitivity, specificity, accuracy of FDG PET/CT in detecting intra- and (or) extrahepatic lesions after TACE were 88.9% (16/18) vs 94.7 % (18/19), 4/4 vs 3/3, and90.9% (20/22) vs95.5% (21/22), respectively. Conclusion 18F-FDG PET/CT is poten-tial useful for detection both intra- and (or) extrahepatic lesions in HCC patients after TACE.